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Maternal smoking has long been linked with increased SIDS risk. The increased risk correlated with how much the mother smokes. Several studies have demonstrated that passive tobacco smoke also significantly increases the risk for SIDS. The risk for SIDS is increased, in normal birth weight infants, about two-fold with passive smoke exposure and about three-fold when the mother smokes both during the pregnancy and the baby continues to be exposed to tobacco smoke after he/she is born.
Kahn and colleagues have shown that infants born to mothers who smoked during pregnancy had lower birth weight, and significantly more episodes of obstructive apnea and excessive sweating (the infants were tested at about three months of life and compared to infants of nonsmoking mothers).
Recent epidemiological studies from New Zealand, Tasmania, and England have reported the prospective results of supine (back) sleep position and significant reduction of SIDS risk. The greatest reduction of risk, however, was found when the infant was placed supine (back) during sleep, was breast fed, and was not exposed to maternal smoking during pregnancy or to passive tobacco smoke following birth.
Recent studies have provided more details on the epidemiology and on possible physiologic mechanisms underlying the association between smoking and SIDS. Kinney et al. have documented significant changes in nicotine-binding sites in the brainstem areas involved with arousal, heart and breathing functions, sleep, and body movement control, during the last half of pregnancy. Thus, mid to late pregnancy may be a particularly vulnerable period for the fetus exposed to the nicotine in maternal tobacco smoke. We do not know exactly how smoking affects the infant during the pregnancy, however, we have several leads which suggest that the effect may influence development of the nervous system.
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Cigarette smoke can trigger worsening asthma symptoms or an asthma attack in some people. Children are particularly sensitive to tobacco smoke as their lungs are smaller and more delicate and are still developing. Passive smoking is breathing in other people’s cigarette smoke. Children who live with smokers have higher rates of asthma than children living with non-smokers.
